William Preston Broughton, DMD
Individual provider Active NPI General Practice Dentistry · Cincinnnati, OH
NPI 1154542280 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1154542280
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 14531 (OH)
- Practice address
- 12 Endicott
Cincinnnati, OH 45218 - Phone
- (513) 825-6277
- NPI assigned
- May 2, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14531 | OH | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Broughton Inc. | General Practice | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 14531 | OH | Yes |
Addresses
Primary practice location
12 Endicott
Cincinnnati, OH 45218
Mailing address
12 Endicott
Cincinnnati, OH 45218
Phone (513) 825-6277
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.